Editorial  |   November 2019
What Is Old Can Be New Again
Author Affiliations
  • N. Martin Giesecke, M.D.
    Editor, ASA Monitor
Article Information
Airway Management / Pediatric Anesthesia / Radiological and Other Imaging / Respiratory System / Technology / Equipment / Monitoring / Editorial
Editorial   |   November 2019
What Is Old Can Be New Again
ASA Monitor 11 2019, Vol.83, 4-5.
ASA Monitor 11 2019, Vol.83, 4-5.
We continue to see new developments in anesthesia. Still, there are many things that seem “new,” but in reality are tried and true discoveries from the past. This edition of the Monitor is focused on Non-operating room anesthesia (NORA). To many, NORA may seem like a recent development. To others, NORA is a recently coined acronym to describe activities that have been going on for some time.
Dr. Belani discusses “Pediatric Non-operating Room Anesthesia (NORA) – The Essentials” in this issue. In this article, Dr. Belani mentions caring for pediatric patients who are receiving radiation therapy. Even back in the 1980s, when my training took place, we were doing NORA on pediatric patients receiving radiation therapy. Back then, we tended to use total intravenous anesthesia with sodium thiopental rather than an inhalational agent-based anesthetic. This technique was chosen as there was evidence back then that these patients maintained a better appetite with thiopental than with potent halogenated agents. Maintaining the patient’s desire to eat was a major benefit, especially when they were NPO several nights each week during the course of their radiation therapy. It is still easy to recall going to the Radiology Department’s treatment rooms to provide this care. Thankfully we do have newer medications with which to sedate pediatric (and adult) patients, so worrying about anesthesia related appetite suppression may be less of an issue.
1 Comment
November 8, 2019
Wayne Walker
NorthBay Medical Center, Fairfield, California
Dead space changes
While additional circuit extensions do not add to the dead space from the Y to the lungs, you may remember that even low compliance extensions allowed enough gas compression with each breath that the patient's end-tidal volume was always less than the delivered ventilator volume.
Submit a Comment
Submit A Comment

Contributors must reveal any conflict of interest. Comments are moderated.

Affiliation & Institution
I have a potential conflict of interest
Comment Title

This feature is available to Subscribers Only
ASA Member Login or Create an Account ×